Day-case robot-assisted laparoscopic surgery: Feasibility and safety.
| Autor: | Ragavan, Narasimhan, Bafna, Sandeep, Thangarasu, Mathisekaran, Prakash, Sanjay, Paul, Rajesh, Chirravur, Pradeep, Ramani, Srivathsan |
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| Předmět: |
ADRENALECTOMY
AMBULATORY surgery SURGICAL excision UROLOGICAL surgery LENGTH of stay in hospitals LAPAROSCOPIC surgery LONGITUDINAL method LYMPH node surgery SCIENTIFIC observation PATIENTS PATIENT safety POSTOPERATIVE care REIMPLANTATION (Surgery) SURGERY SURGICAL complications PLASTIC surgery URINARY diversion COMORBIDITY PILOT projects SURGICAL robots DISCHARGE planning TREATMENT effectiveness PATIENT readmissions NEPHRECTOMY DESCRIPTIVE statistics EVALUATION |
| Zdroj: | Turkish Journal of Urology; Jan2021, Vol. 47 Issue 1, p30-40, 5p |
| Abstrakt: | Objective: The delivery of surgical services has undergone a shift in the past decade with increasing numbers of surgeries being performed in the daycare setting. Implementing a minimally invasive surgical approach with a robot with an enhanced recovery protocol permits robot-assisted laparoscopic surgeries (RALS) to be performed as a day-case (DC) procedure. This study aimed to assess the feasibility and safety of DC surgery according to our experience. Material and methods: In this prospective observational study, 43 patients underwent DC RALS performed by a single surgeon over 18 months [simple nephrectomy (n=7), radical nephrectomy (n=15), radical nephrectomy with para-aortic lymphadenectomy (n=5), and adrenalectomy (n=5)]. In addition, reconstructive urological procedures that included pyeloplasty (n=9), ureteroureterostomy (n=1), and bladder diverticulectomy with ureteric re-implantation (n=1) were performed as DC surgeries during this study period. RALS was performed in the standard way with an enhanced recovery pathway of care for DC. We collected data regarding the demographic information, medical comorbidities, preoperative outcomes, intraoperative outcomes, complications, length of stay, and readmission rates. The data were analyzed and evaluated. Results: All the patients (100%) were successfully discharged on the same day with no major complications (Clavien--Dindo grade>I). The readmission rates were 0%. Conclusion: DC RALS are safe and feasible with an enhanced recovery protocol. With adequate protocols in place, these surgeries might prove to be better than the available minimally invasive techniques and can become the standard of care in the future. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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